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Family
Family is a third season episode of House which first aired on May 1, 2007. A bone marrow transplant to a critically ill patient is threatened when the donor, his younger brother becomes ill as well. Although the younger brother doesn’t appear to be in danger from his illness, the team’s techniques to diagnose him in time to help his brother bring him to the brink of death as well. When it seems the parents must choose between their sons, Foreman decides to do something that may save both of the brothers at the cost of confronting a part of himself he may not be able to live with. Meanwhile, House tries to deal with Wilson’s old pet dog Hector and his habit of chewing everything in sight. By this point in the series, we're already aware that every one of the main characters has some kind of issue with their family. In this episode, those children of dysfunctional families have to deal with a family that, at least at the beginning of the episode, only has issues to deal with that are out of their control. It's clear that everyone in Matty's family cares deeply about everyone else in the family. That's what makes their ordeal so difficult. House, in his usual display of objectivity, is able to put what feelings he may have aside to take the best course of action. Naturally, this pushes the family past the breaking point. But at least the family that inspires the title is, at the end of the episode, back intact with everything being as normal as it could be. Matty can even go back to baseball. They once again can start caring about each other and it's that caring that got them through the ordeal. By contrast, House's insistence on approaching each and every problem without emotional context, and insisting those working with him do exactly the same, pushes them past the breaking point. By the end of the episode, Foreman has become a perfect House clone - the exact doctor that House wanted him to be because he always knew Foreman had it in him. When Foreman goes against instructions, House had nothing but praise for him. It's exactly what House would have done in the same place. Just like Matty's father is proud of his sons, House is proud of Foreman. But while Matty's family survives because they care, House's surrogate family is destroyed because Foreman can't put aside his feeling. House failed to account for the fact Foreman not only cares about other people, but about himself. He's ready to leave and House realizes he's ready to go. Contrast this with Chase's path, which takes longer, but has the same result and better consequences. Foreman felt he had to be House, but couldn't live with the consequences. Chase realized he couldn't be House but, once he realized that, he realized he could still be himself and be a great doctor too. Recap A young man is getting ready to donate bone marrow to his older brother with leukemia when all of a sudden he sneezes in front of Wilson. House is trying to adjust to his new dog Hector, who has a habit of chewing things, including his cane. Wilson reports to the team that the younger brother has an infection with an enlarged spleen and fever, and that they have five days to complete the bone marrow transplant, otherwise the older brother will die because his immune system is compromised. Foreman is already treating the younger brother with antibiotics, but they will take too long to work. Chase reports that the younger brother has tested negative for all the common infections. House suggests encouraging the infection so that the type of infection becomes obvious. Foreman suggests going to their home to search for an infection source. Wilson and House discuss making the younger brother sicker with the parents. House pushes the procedure on them. House and Wilson get into an argument about needing to have a good relationship with patients. House feels Wilson's good relationship with patients would make it easier to manipulate them. Foreman and Chase do the environmental scan. Foreman still feels bad about the patient who died in House Training. They find an old water pump that they feel could be the source of an infection and Chase takes a sample. Back at the hospital, they chill the younger brother to make him sicker. The patient tells Foreman and Chase that he hasn't tasted water from the pump in months. The patient tells them his testicles have swollen. House is enthusiastic because it narrows down the diagnosis. Foreman plans to look for another marrow donor in case they can't figure it out. Cameron and Chase check for infections that cause swollen testicles. Chase once again tells Cameron how he feels about her, something he plans to do every Tuesday. Chase thinks that the problem may not be an infection despite his fever. There are signs of a cardiac injury in the patient's tests and he feels the swollen testicles may be the result of a heart problem. Chase and Cameron examine the patient's heart. They discover a growth on the mitral valve, which will take at least a month of antibiotics to heal. It appears to be a direct result of making the patient sicker. House suggests replacing the infected valve and treating the patient's marrow with antibiotics. Foreman argues with Cuddy that the procedure would be too dangerous to the younger brother. Cuddy tells Wilson to go to the parents to tell them the risks, but not to let House bully them. House confides in Cuddy that Foreman has lost his edge, and that he will fire him if he doesn't shape up in the next four days (the same deadline as the marrow transplant). They speak to the family about the risks to the younger brother, and they decide to allow the valve replacement. However, the younger brother is not told about the risks, one of which is that he won‘t be able to participate in sports because of the blood thinners he will have to take for the rest of his life. However, a biopsy of the growth indicates the growth is fibrous, not an infection. The heart valve replacement won't help. Meanwhile, Hector has eaten House's drugs and gotten stoned. The fibrous growth and other symptoms indicate an autoimmune disease. If it is an autoimmune disease, he can still be a marrow donor. House tells them to find out which autoimmune disease it is—there are very few of them and it will take almost no time to check. Meanwhile, the older brother’s arm starts to bruise, showing his capillaries are breaking down. House’s cane breaks as he’s walking, thanks to Hector’s chewing. House vents about Hector to Wilson. Wilson suspects House left the drugs out for Hector to find. Hector has chewed through House’s cane and an rare old Elvis Presley 78. The team tells House the patient doesn't have an autoimmune disease and the older brother is getting worse. Meanwhile, Foreman has found a 67% match bone marrow donor. Wilson and House try to talk the family out of it because of the risk of complications, but the family wants to proceed with the partial match. House is angry that Wilson backed down in face of a bad decision by the parents. Foreman may have been wrong, but he was doing what he thought was right. Wilson backed down even though he was right. They give the older brother the 67% bone marrow match transplant. House once again tries to get rid of Hector by "accidentally" leaving his door open. When he returns home, his stereo is gone, but Hector is still there. As House heads to another room he shuts the door behind him, only to hear Hector scream in pain having been hit by the closing door. The younger brother is upset he can't visit his older brother because of his infection. While Cameron is treating him, the patient starts bleeding out of his ears. House drags Wilson along to pay for a new cane and apologizes for calling him a coward. House hears about the bleeding and figures the patient's bone marrow has shut down, just like his brother. Now the younger brother will die if they can't figure out what is wrong. They have to stop his medication until his marrow rebounds. House buys a cane with a flame stripe. The older brother has developed graft vs. host disease and isn’t responding to methylprednisolone. The young patient is getting worse despite being taken off medication. House comes up with the idea of putting the younger brother's marrow into the older brother to let the infection spread faster and find out what it is. House tells the parents its the only way they can save the younger brother, but the older brother will die—otherwise both sons will die. Wilson agrees. However, the parents refuse to give up on the older brother, risking both of their children. Foreman wants to run more tests on the younger brother, but House believes it's futile because of the range of possible diagnoses—it will take months to run through the possibilities. Foreman leaves to start the tests anyway. House goes to tell the older brother he is dying. He tells him he can save his brother by risking his own life. While they run tests, Wilson and Foreman discuss the water pump and Foreman's future at the hospital. Wilson wonders why the family has a water pump where they live, which is a suburb with municipal water. The older brother wants to go through with being infected to save his brother, and the parents finally agree. However, Foreman determines the answer—histoplasmosis, a fungal disease, most likely from chicken feces dug up from the farmland the house was built on. The younger brother can be treated, but his marrow still won't be any good for his older brother because the infection has attacked it—there isn't enough of it to treat the older brother. While he treats the younger brother, Foreman tells him his brother was willing to risk his life for him, and asks if he would be willing to do the same. The younger boy says he would. Foreman tells him he is too sick to receive anesthetic for the pain the marrow removal procedure will cause, but the boy still wants to go ahead. The patient screams in pain and wants to stop after the first extraction, but Foreman says he needs a lot more and plunges back in, causing the boy agony. The transplant is successful and both sons live. Wilson tells House to tell Foreman he did a good job on the case. House says Foreman already knows that. Hector is in the office, chewing on Wilson's stethoscope. Wilson tells House Hector can go back to his ex-wife. Hector limps towards Wilson, favoring his right paw just like House. House has a replacement stethoscope ready. He tosses Hector a Vicodin, which Hector gulps down like candy. Later, Foreman talks to House. House tells him he did good. Foreman is glad he saved both patients, but is upset that he feels that to be as good a doctor as House, he has to have more of House's personality. House expresses his opinion that Foreman has always had House's personality. However, Foreman has no intention of being under House's influence any longer, and gives two weeks notice of his resignation. Zebra Factor 4/10 Histoplasmosis is common in the environment, but severe infections are rare. One famous person who developed it was Bob Dylan, who was hospitalized. Title The title focuses on the relationships, decisions and sacrifices of the nuclear family in the episode. Trivia and Cultural References *Hector is a West Highland White Terrier, first recognized as a separate breed in 1908 *Hector's taste in footwear are Nike Shox, which retail for well over $100 U.S. *House’s calculation of Hector’s age is based on the rule of thumb that a dog’s lifespan is about 1/7th as long as a human's, so one dog year is the equivalent of seven human years. He comes up with the right answer given that Hector is 17—the equivalent of a 119 year old human. *House also makes a reference to making the needle big enough to let a camel through it. This metaphor is found in several cultures, but the most famous reference is probably from the New Testament: “It is easier for a camel to go through the eye of a needle than for a rich man to enter the kingdom of heaven“. *"GM" is General Motors, the largest automobile manufacturer in the United States. *The Yips is a phrase used to describe the loss of fine motor skills in an athlete. It is most often used when a golfer starts to have trouble making putts on a consistent basis. *Steve Blass is a former major league baseball pitcher. His earned run average leaped from 2.49 in 1972 to 9.85 in 1973. He retired after giving up five runs in five innings in his only appearance in 1974. *Scott Norwood was the field goal kicker for the 1990 Buffalo Bills. He missed a possible game winning field goal wide right in Super Bowl XXV. *David Duval was a professional golfer. After his 13th professional victory in the 2001 Open Championship, he never finished first again. By 2011, his play had deteriorated so greatly he lost his tour card. Once the #1 money winner on the tour, he finished 80th in 2002 and out of the top 100 in 2003. *The sport that House had on television when he was sleeping was Curling *78 rpm was the standard revolution speed for records from about 1925 to the 1950s. The discs were referred to as “78s” to distinguish them from 33 rpm and 45 rpm records. The early recordings of Elvis Presley by Sun Records were released on 78 rpm discs. 78s generally faded from use in the 1960s as 45 rpm records, which were smaller, had better sound and were less likely to break replaced the format. *When House goes to the tobacco shop to look for a new cane, he picks up a calabash pipe, the type preferred by Sherlock Holmes. *Marilyn Manson is an American singer-songwriter who fronts a band by the same name. He often performs with a skull capped cane onstage. *The line "all the usual suspects" is from Casablanca Goofs * Polite Dissent was not impressed with the medicine. ** The shoulder pain was never explained ** The increased CKMB was never explained ** Not only was the acute scrotum never explained, House should have done an ultrasound to rule out testicular torsion, a serious condition ** Histoplasmosis symptoms are generally mild in a patient who is not immunocompromised. It's really only dangerous in patients with a severely compromised immune system, such as someone with AIDS. ** As has been pointed out several times, even in an immunocompromised patient, fungal infections spread slowly due to their slow growth rate, even in ideal conditions. ** Similarly, although amphoteracin is effective, it kills fungi slowly (once again due to the fact fungi grow slowly - they spread slowly and die slowly) ** Removing white blood cells may allow an infection to spread more quickly, but it will also alleviate many of the symptoms associated with an infection, such as fever. ** Cuddy and Foreman directly contradict each other about the treatment for histoplasmosis and the effect on being able to give a transplant in the circumstances. ** Narrow spectrum antibiotics do not work faster than broad spectrum antibiotics. The only difference is that narrow spectrum antibiotics work against fewer infections, often those that don't respond to broad spectrum antibiotics. ** Cameron's statement that Matty's blood was "turning to water" is not accurate. Blood plasma contains many proteins even if it contains no red blood cells or white blood cells. ** Finally, and more importantly, even in a sick patient, giving anesthetic is a lot safer than giving them a treatment that causes intense pain. Such pain could put a patient into shock, which could be fatal in Matty's weakened condition. * The team notes that the patient has no lung problems, but histoplasmosis usually presents with lung symptoms first. * The explanation of graft versus host disease is almost completely incorrect. Although it is the most common complication of a transplant, in a 4/6 donor it is usually not as serious as the team describes. * The activation of a heart-lung bypass machine will not automatically stop the heart. In fact, a healthy heart will continue to beat even after it is removed from the body. In surgery, it must be stopped chemically, generally by using a potassium solution. * Although an infection can cause an acute scrotum, it is unlikely to do so in a patient of Matty's age. Major Events * Foreman is revealed to have turned to God in order to help him cope with having killed a patient by mistake. * Chase's own incident where he accidentally killed a patient is brought up again. * House reveals that he plans to fire Foreman soon. * Hector chews on House's cane, causing it to snap and House to lose his cane. * Foreman goes behind Wilson's back to tell Nick and Matty's parents that they've found a new donor, a move which angers Wilson. * In revenge for having his belongings needlessly destroyed, House slams a door on Hector, crippling the dog in the process. It's also possible that House trained the dog to limp as Hector limps intermittently and offers up a treat at the end when the dog does so. * In an attempt to let Hector escape, House inadvertently allows his stereo to be stolen instead. * Wilson buys House a new cane, one with flames at the end. * Distraught over the way he acted to help both patients and believing that he's started acting like House, Foreman gives House his two weeks notice. Reviews * IMDB users rated the episode an 8.5 with 28% of users rating it a "10". It did best with females 18-29 and females 45+ (8.8) and worst with males 45+ (8.0) * TV.com users rated the episode an 8.7. They chose Jesse Spencer as their Most Valuable Performer. Medical Ethics Environmental scans This is certainly not the first time the team has crossed ethical boundaries and patient privacy in this manner, and it would be far from the last. Naturally, it appears this technique is not recognized in medical ethics at all, except for general research purposes where it is often common to seek out factors that may influence disease clusters. As a rule, in a physician-patient relationship, a physician must limit their inquiries to a series of interviews and this is a well recognized technique that goes well outside what would be collected in a typical medical history. Epidemiology is probably the medical field where this technique is most commonly used. For example, when the CDC is investigating a disease outbreak, they will examine every possible source of contamination or contagion. However, sometimes they get it wrong, as in the case of Gaetan Dugas, a French-Canadian flight attendant who was branded "patient zero" in the AIDS epidemic although later research found not only was the spread of the disease wider than the gay community (Dugas was just one of many patients who had the disease in the 1970s), but that doctors identified AIDS patients from as early as the 1950s. Bypassing parental consent The team is correct. In all cases, parents have final say over medical care over minors. It is only in cases where the patients are acting in an unreasonable manner that a hospital may seek out a court order to appoint a guardian ad litem for a minor patient. In this episode, this basic concept is observed more in the breach than the observance. Not only does the team regularly override explicit and reasonable decisions made by the patients, at the end they stop seeking parental input at all. As many team members have pointed out in other episodes, it is difficult enough for a patient or a parent to understand the risks of a given medical procedure and, in this case, where the team is clearly going outside established clinical guidelines, it is arguable that informed consent just isn't possible. Here it is clear the parents are only minimally cognizant of the risks involved in the recommended procedures. This is made worse by the fact that House feels bound to get consent at any cost, whereas Cuddy and Wilson rightly recognize a patient may and should reject a procedure with too high a risk to benefit ratio. It's even more clear that Matty and his brother are just not in a position to understand the risks of what they're about to go through. Causing pain to a patient Pain management in a patient requires close co-operation between the physician and the patient as well as a deep understanding by the physician about the risks of pain management options. No pain management option is completely without risk. Even a local anesthetic can cause serious complications either by clumsy administration (which can affect parts of the body other than those intended) or through improper dosing (which can be toxic). In the past, before the development of anesthesia, pain management during the procedure was known to have limited effect. Laudanum, a mixture of wine and opiates, could provide some relief, but for the procedures that were possible (basically tooth extraction and amputation) it was clearly insufficient. Even with modern techniques, some normal procedures, like childbirth, require pain management techniques that pose risks, such as the use of an epidural. In this case, it does not appear Foreman even considered alternatives to general anesthetic. As has been pointed out (see the Goofs section), in this case general anesthetic, no matter how ill-advised, poses a lower risk than putting the patient in so much pain that they risk shock. In addition, even if general anesthetic was impossible, Foreman didn't consider even something as straightforward as a local anesthetic, narcotics or even NSAIDs. In real life The episode is similar to the real life case of David Vetter, often referred to in the media as the "Bubble Boy". Vetter suffered from severe combined immunodeficiency and had to live in an isolated environment from birth. At 13, doctors attempted a bone marrow transplant from his sister in order to stabilize his condition. However, due to an undiagnosed case of the Epstein-Barr virus in his sister, he developed mononucleosis and died from it. Cast *Hugh Laurie as Gregory House *Lisa Edelstein as Lisa Cuddy *Omar Epps as Eric Foreman *Robert Sean Leonard as James Wilson *Jennifer Morrison as Allison Cameron *Jesse Spencer as Robert Chase *Adina Porter as Claudia *Thomas Mikal Ford as Scott *Jascha Washington as Nick *Dabier as Matty *Greg Cipes as Salesman *Bobbin Bergstrom as Nurse Quotes Dr. Wilson: I treat patients for months, maybe years! Not weeks, like you!'' ''Dr. Gregory House: I'm taller.'' ''Dr. Eric Foreman: He has... acute scrotum.'' ''Dr. Gregory House: Adorable. Please... much more dignified... C'mon, how am I not supposed to make that joke?'' ''Dr. Gregory House: seeing hs new cane Bitchinnnnn...'' ''Dr. Gregory House: You have only one decision to make: do you leave here with one dead son or two?'' ''Dr. Wilson: We just had to make sure you weren't exposed to any bugs, because your healthy bone marrow is what's gonna cure your brother's leukemia.'' ''Matty: {sneezes]'' ''Dr. Gregory House: Foreman Hey, you're not gonna believe what happened. Wilson just killed a kid same way you did.'' ''Dr. Wilson: He's not dead.'' ''Dr. Gregory House: Five days are just gonna fly by. He didn't look both ways before he nuked.'' ''Dr. Gregory House: You did good.'' ''Dr. Eric Foreman: I did what you would have.'' ''Dr. Gregory House: Well, maybe I'm biased, but...'' ''Dr. Eric Foreman: I tortured the kid.'' ''Dr. Gregory House: Because you knew it was right. You knew you were saving his brother.'' ''Dr. Eric Foreman: I know. I don't like that I know. I hate that I can listen to a kid screaming in pain and not even take a moment to question whether I'm doing the right thing. I hate that in order to be like you as a doctor, I have to be like you as a human being. I don't want to turn into you.'' ''Dr. Gregory House: You're not. You've been like me since you were eight years old.'' ''Dr. Eric Foreman: You'll save more people than I will. But I'll settle for killing less. Consider this my two weeks' notice.'' ''Dr. Allison Cameron: No way we can solve this that fast. You need to find another donor.'' ''Dr. Wilson: They're African-American. It makes it nearly impossible to find a full match.'' ''Dr. Gregory House: Tell me about it. I can't even find the one I've got working for me. Where is Foreman?'' ''Scott: So e... exactly h... how sick are you gonna make Matty?'' ''Dr. Wilson: He could get quite ill. This certainly won't be a pleasant experience for anyone, but it's our onl...'' ''Dr. Gregory House: Ever get caught in the rain without an umbrella? That's all we're talking about here. Sign the form.'' ''Dr. Wilson: It's a little more complicated than that. We'll also be doing leukapheresis. We run Matty's blood through a machine that filters out his white blood cells.'' ''Claudia: But without his white cells, how can he get better in time?'' ''Dr. Wilson: We'll pump the white blood cells back as soon as we have a diagnosis. Then we should be able to cure the infection in time to do the transplant.'' ''Scott: But you can't guarantee?'' ''Dr. Gregory House: We're not GM! No recalls, no rebates. Any more questions while your son's life slips away?'' ''Dr. Gregory House: Cuddy Wilson's right, Foreman's wrong and your shirt is way too revealing for the office.'' ''Scott: Open-heart surgery?'' ''Dr. Gregory House: If you want both kids to live, it's the only choice.'' ''Dr. Wilson: Due to the valve replacement, Matty will have to be on blood thinners to prevent potential clots.'' ''Scott: For how long?'' ''Dr. Wilson: Forever. He couldn't participate in contact sports because of the risk of hemorrhage.'' ''Claudia: What about the marrow registry? Maybe they'll find a match.'' ''Dr. Gregory House: Maybe they'll ride it here on a unicorn.'' ''Dr. Eric Foreman: The family has one kid with leukemia and one with autoimmune. Wouldn't stand next to them in a rainstorm.'' ''Dr. Gregory House: That's your argument? It sucks for them?'' ''Dr. Wilson: How exactly does a dog unscrew a bottle of pills?'' ''Dr. Gregory House: Is that a riddle?'' ''Dr. Allison Cameron: Are you okay?'' ''Dr. Gregory House: I just tripped over Wilson's self-righteousness.'' ''Dr. Allison Cameron: Nick's starting to deteriorate fast. He's got bruising all over his arms.'' ''Dr. Robert Chase: Capillaries are leaking blood. If it happens in his brain, he's dead.'' ''Dr. Allison Cameron: We've got to go with the 4 out of 6 donor.'' ''Dr. Gregory House: Hmm. Did I mention my concerns about 4 being less than 6? Wilson's first wife ignored a similar issue. Of course, that time, it was only fatal to their marriage.'' ''Dr. Wilson: Foreman screwed us.'' ''Dr. Gregory House: No! You screwed us. What is the point in being able to control people if you won't actually do it? It's like training a dog and then letting him go on your rug which, by the way...'' ''Dr. Wilson: Once Foreman got his mitts on them, there was no way...'' ''Dr. Gregory House: You don't explain chances and probabilities. You lie to them. You tell them Foreman's a moron which isn't even much of a lie right now.'' ''Dr. Wilson: You gotta to talk to him.'' ''Dr. Gregory House: I got no problem with what Foreman did.'' ''Dr. Wilson: He undercut us and he may have cost that kid his life!'' ''Dr. Gregory House: Well, he did what he thought was right! You, on the other hand, sucked out! When the decision really mattered, you didn't have the guts to tell them what to do! If that kid dies, it's because Foreman was wrong and because you're a coward!'' ''House: Nothing like a dead patient to send you back to your choir boy roots.'' ''House: You done talking to your imaginary friend? 'Cause I thought maybe you could do your job.'' ''House: All you had to do is say 'Yes, I do'. God knows it's a phrase you've used often enough in your life.'' ''Wilson: It was a mistake every time. Give it a break. They said yes.'' ''House: That's not enough for you. You need them to feel good about saying yes.'' ''Wilson: I treat patients for months, maybe years, not weeks likes you.... If they don't trust me, I can't do my job.'' ''House: The only value of that trust is you can manipulate them.'' ''Wilson: You should write greeting cards.'' ''House: Giving parents the chance to make a bad choice was a bad choice.'' ''Wilson: At least it would have been their choice.'' ''House: One they'd regret at their son's funeral.'' ''Foreman: You obviously think your time could be better spent. Why'd you come along?'' ''Chase: I feel bad about what happened last week.'' ''Foreman: I'm handling it.'' ''Foreman: I killed her a week ago and I can't remember what color top she was wearing.'' ''Chase: I was grateful when I could wake up not thinking about her.'' ''Foreman: I'm not like you. You're patient died because you were distracted over the death of your dad. I made a calculated decision. You acted like a human being. I acted like— House.'' ''Cuddy: Did he really think I was going to do that?'' ''House: I didn't.'' ''Cuddyy: Then why did you—'' ''House: Tried to cut him some slack.'' ''Cuddy: Nice of you.'' ''House: I think he's got the yips. Steve Blass, Scott Norwood, David Duval all got the yips. Great athletes. Lost their confidence and immediately starting sucking.'' ''Cuddy: And you're giving him time to work through it?'' ''House: Mm-hmm. Four days. Then he's fired. you don't get better from the yips.'' ''House: That was awesome!'' ''Wilson: Shut up.'' ''House: I gotta start pretending to care.'' ''Wilson: I did exactly what Cuddy told us not to do.'' ''House: No, you didn't. You did exactly what she told me not to do. You're completely in the clear. You've got to be kidding me. You're actually upset. You just said what you believed.'' ''Wilson: I also believe in patients making their own choices.'' ''House: Because it lessens your guilt if things go wrong. You're not protecting their choices You're soothing your conscience.'' ''Wilson: By that logic a sociopath would make the best patient advocate in the world.'' ''House: Am I blushing?'' ''Wilson: You call me a coward, life goes on?'' ''House: Apparently. You showed up. turns to leave Hey. I'm sorry.'' ''Wilson: Okay.'' ''House: You're pathetic. I didn't actually mean that.'' ''Wilson: Yes, you did.'' ''House: No I didn't. To infinity'' ''Wilson: Yes, you did. You're pathetic'' ''Wilson: The marrow transplant took.'' ''House: Welcome back, Foreman.'' ''Wilson: You should talk to him.'' ''House: And tell him how proud I am?'' ''Wilson: Hey if you're ashamed of him, you can tell him that.'' ''House: Pride and shame only apply to people we have a vested interest in, not employees.'' ''Wilson: How many hours a day do you have to spend with someone before they're basically family?'' ''House: Good point. But first I gotta tell Cameron and Chase that they're violating God's will.'' ''Wilson: I'm just asking you to have an adult conversation to let him know—'' ''House: He did a good job? He knows it. Adults don't need adult conversations. Just like I don't need this conversation.'' ''Wilson: Have you killed Hector yet?'' ''House: How old is Hector?'' ''Dr. Cameron: Our patient's name is Matty. His brother's Nick.'' ''Dr. Wilson: Hector's my dog. He's about seventeen.'' ''House: Seventeen? That's like... a hundred and nineteen in human years. Why's he still alive?'' ''House: Ten thousand possible infections, at least 20 minutes per test, take you approximately eight years.'' ''Dr. Foreman: Actually, four months, assuming the last one I test is the right one. If it's the first, it'll take me approximately 20 minutes.'' ''Dr. Wilson: He's right, it's worth a shot.'' ''House: He's timid. Testing blindly is not gonna save this kid.'' ''Dr. Foreman: But standing around here will.'' ''Dr. Wilson: We're done with Nick?'' ''House: God is done with Nick.'' ''Dr. Foreman: I want to recheck the national marrow registry for an alternate donor.'' ''House: In case we're wrong?'' ''Dr. Foreman: It's been known to happen.'' ''Dr. Cameron: Flames?'' ''House: Makes it look like I'm going faster.'' ''House: You want to catch a movie?'' ''Dr. Wilson: It's one in the morning.'' ''House: I know a place. Although I wouldn't recommend wearing those shoes.'' ''House: You're a sneaky bastard. Any ideas how we get around this?'' ''Dr. Chase: Court order.'' ''House: That's hardly sneaky.'' ''House: Wow, he sure is hurting.'' ''Scott: Nurses said he maxed out on his pain meds.'' ''House: If I had a nickel for every time I've heard that.'' ''Dr. Foreman: I hate that in order to be like you as a doctor, I have to be like you as a human being.'' ''Salesman: Genuine bull penis stretched over a metal rod.'' ''House: Penis canes are murder.'' ''House: If that kid dies, it's because Foreman is wrong and you're a coward.'' Music * Highway to Hell by AC/DC - When House and Wilson return from buying the cane * Ain't No Reason by Brett Dennen - In the final scene Release Dates * United States - May 1, 2007 on Fox * Canada - May 1, 2007 on Global * Netherlands - November 1, 2007 on SBS6 * Greece - February 9, 2008 on Star Channel * Germany - April 15, 2008 on RTL * Hungary - April 23, 2008 * Czech Republic - April 28, 2008 on TV Nova * Japan - October 14, 2008 * Sweden - November 18, 2008 on TV4 * Finland - December 25, 2008 In Other Languages * French - Deux Frères (Two Brothers) * Spanish - ''La Familia ''(The Family) Links *Episode page at IMDB *Episode page at House MD Guide *Episode article at Wikipedia *Episode summary at TV.com *Soundtrack listing at Tunefind *Soundtrack listing at What Song *A review of the medicine at Polite Dissent (via archive.org) *Episode transcript at Clinic Duty ''This article was the featured article for April, 2019Category:Season 3 Category:Episodes Category:Featured articles